In the early 1990’s, while still in medical school, I attended a medical conference sponsored by the American Holistic Medical Association. One of the several interesting topics discussed was chelation therapy. At the time, I did not have a specific understanding about chelation therapy. It is an IV protocol full of vitamins, minerals and a specific amino acid, EDTA, that was purported to help circulation and cardiovascular disorders. But for many reasons, some of which were very unclear at the time, it was held in fairly high disdain by the orthodox medical community.
Soon thereafter a friend called whose father had been recently diagnosed with significant cardiovascular disease. He had undergone a stent placement which ultimately failed. Unfortunately he was considered not healthy enough to undergo a bypass surgery. He was also on 12 different medications, and had an abysmal quality of life. His physicians advised him it would be wise to get his ‘affairs in order’. My friend had asked me if there were any other options, knowing of my interest in a more integrative model of health and healing. I then remembered the lecture about chelation therapy. I told her I did not really know about it, but many experienced physicians I had met at the meeting were firm believers and had observed very positive results. She did further research, and discussed it with her father. She then took her him to visit a physician in the Indianapolis, Dr. David Darbro, that did chelation therapy. I was amazed that once initiating the therapy he was actually able to eventually discontinue all his medications. He said that he had not felt that well in many years. He began playing golf again, and enjoying activities that he had been previously not been able to participate. His transformation to wellness took about two months. I was impressed that the ‘experts’ had only given him weeks to live.
I was so intrigued by this interesting therapy that a couple years later, while in residency, I was able to arrange time with my residency program to spend time at Dr. Darbro’s office as an elective. I met several patients that had underwent chelation therapy. I had the chance to talk with many of those directly. What intrigued me the most was that it seemed like no matter what ailment, condition, or anomalous medical challenge they faced, all of them felt better, often dramatically. I was amazed that such a simple therapy seemed to have such far-reaching beneficial implications. I was more surprised to find that, for various political and philosophical reasons, the orthodox medical community did not always warmly embrace the adjunctive use of chelation therapy.
Following that experience I began to attend medical meetings hosted by the Great Lakes Association of Clinical Medicine (GLACM) which, ultimately, became the International College of Integrated Medicine (ICIM). Again, I had the opportunity, even as a resident in Family Practice, to meet many clinicians who were doing these innovative therapies with impressive outcomes. The results were light years better than what I had observed when during my medical education.
Over the years, there has been considerable criticism from the medical community about chelation therapy. The pronouncements portrayed it as unproven, and not scientifically valid. This seemed an unusual position to take given that several publications already existed in the medical literature. In addition, it was well documented that chelation therapy effectively several toxic metals including, lead, mercury, aluminum, arsenic, and cadmium.(to name a few). Everyone is exposed to environmental toxins to varying degrees, depending on our environment. We have varying genetic abilities to detoxify, but if the toxins build up in our bodies, it could be an impediment to normal cellular function. So, it would not necessarily be surprising that removing heavy metal toxins via chelation therapy could have far-reaching beneficial effects. Unfortunately large scale clinical trials, until recently, had not been conducted to evaluate this association. That necessity spawned the Trial to Assess Chelation Therapy (TACT). This trial was sponsored by the NIH. The lead researcher, Gervasio Lamas, M.D., had no direct experience with chelation therapy, but as a scientist, recognized the importance of research designed to discern the potential efficacy of chelation therapy.
Despite approval of the trial, naysayers seemed intent to obstruct the progress of the trial by offering negative commentary. One such article, published in the Medscape Journal of Medicine in 2008, bore the inflammatory title, “Why the NIH Trial to Assess Chelation Therapy (TACT) Should be Abandoned”. They concluded in their lengthy discord that the TACT trial would be, “pointless, dangerous, unethical and should be abandoned”. This was a strong position to take, but it does illustrate political tensions which exist concerning chelation therapy. When the trial was unblinded in August 2012, it was noted by Dr. Lamas that, “an improbable event had occurred.” In effect, despite the skeptics, the trial actually showed specific clinical benefit. This was especially the case with diabetic patients. In the subsequent arm of the study, using chelation therapy, and high dose multi-vitamins, the outcome showed a 40 percent reduction in all-cause mortality and morbidity inclusive of cardiovascular events. Interestingly, this exceeds the efficacy of prescription drug therapies. No doubt, those who are wedded to their criticism will probably remain undeterred. That said, even those who have historically been staunch critics, have taken a more neutral position. Harlan Krumholz, M.D., a Yale cardiologist, had stated in an interview that, “he does not feel comfortable ignoring the large, federally funded chelation trial know as TACT, even though he was stunned by the positive conclusions and wants more evidence before he was willing to advise chelation for his patients”. While not a ‘green light’ endorsement, he went on to say that, “if you are going to do a study, you need to live with the results”, and, “just because it’s an inconvenient result, I cannot dismiss it”. It found it interesting that he also stated that he would have believed the trial more if it would have found chelation to be dangerous and ineffective. Unfortunately, strongly held perceptions are slow to dissipate.
The other component that I thought of great interest was the study design itself. While out of necessity, it was basic and pointed. In reality, most patients who visit doctors who do chelation therapy would have engaged a more comprehensive therapeutic program. In this study, a simple infusion of EDTA, vitamin C, magnesium, potassium, sodium bicarbonate, pantothenic acid, procaine, Heparin and sterile water was used in addition to basic multi-vitamins. Even with that this very basic regimen, the fourth arm of the study, using chelation therapy and high dose multi-vitamins, showed a 40 percent improvement. In the real world clinical setting patients are receiving IV protocols that are substantially improved over the basic one provided in the TACT trial. The therapies are individualized, and often use additional adjunctive nutrients that would enhance the therapeutic effects. In addition, other patients are incorporating synergistic approaches such as Enhanced Extracorporeal Counter-Pulsation[EECP] to help improve circulatory problems. Additionally, lifestyle changes, optimal physical activity, improved diet, and more extensive laboratory analysis, balancing of the hormone system, and managing inflammation.(to name a few)
Doctors who have routinely practiced chelation therapy for years know intimately of its obvious benefits. I would anticipate a real world study would show substantially more benefit than the 40% noted in the TACT trial. Perhaps that would be a logical follow-up study. For example, this concept was evaluated in a small scale study using 59 patients. Dr. Elmer Cranton, showed a 90 percent reduction in cancer mortality in individuals undergoing chelation therapy. Studies such as this would be well worth considering doing in a more expanded version, especially given the copious published clinical data demonstrating a causal link between low levels of toxins, such as cadmium, to eventual development of cancer, such as prostate cancer. It should be noted that the side effect profile of the TACT trial was negligible. In comparison, the ENHANCE trial, patients given a combination of two cholesterol lowering drugs, Zocor and Zetia, demonstrated greater arterial plaque, and no fewer heart attacks in the study group. In addition, there remain several concerns regarding the risks of statin drugs. This includes an increased risk of Parkinson’s disease, cancer, neurologic complications, autoimmune diseases, and glaucoma(to name a few). Well documented side effects are fairly common; forgetfulness, decreased libido, fatigue, muscle and joint pain, potential liver complications. Sometimes side effects can be serious, and even life threatening. The chelation trial, however, showed none of these complications.
In essence, I do think that the world of medicine has opened a new era of understanding the subtle interplay of heavy metal toxicology and the role of chelation therapy. Not only in cardiovascular disease, but probably as an adjunct helpful for many other areas as well.
~ Dr. Guyer
